In the field of acute care surgery, leveraging technological advancements to enhance intraoperative visualization and precision is an area of growing importance. Despite significant progress in surgical technique, complications such as anastomotic leaks, bile duct injuries, and undetected ischemia continue to pose substantial risks, particularly during emergency and trauma procedures. The introduction of indocyanine green (ICG) fluorescence-guided surgery, paired with near-infrared fluorescence (NIRF) imaging, has emerged as a transformative approach, promising real-time assessment of tissue perfusion, anatomical delineation, and improved surgical outcomes. Recent studies highlight the potential of ICG-guided methods to reduce intraoperative errors and post-operative complications, evidencing significant improvements in patient safety and surgical efficacy, especially in high-stakes, time-sensitive settings. Nonetheless, key challenges remain, including optimizing ICG dosing and administration, defining best practice protocols for device use, and objectively quantifying fluorescence signals for decision-making at the operating table.

This Research Topic aims to advance the understanding and adoption of ICG fluorescence-guided surgery in acute care and emergency settings. We seek to clarify the impact of these innovations on clinical outcomes, explore best practices for perioperative management, and identify strategies to overcome barriers hindering widespread implementation. Central to this aim are questions regarding the standardization of perfusion and ischemia assessment, optimal device and dosing protocols, as well as the integration of robotics and quantitative fluorescence technologies. By consolidating evidence, encouraging the development of guidelines, and fostering interdisciplinary collaboration, this topic aspires to drive the next phase of innovation and clinical translation in this rapidly evolving field.

This Research Topic primarily focuses on the practical applications, clinical benefits, and future directions of ICG fluorescence-guided surgery in emergency and acute care environments. It does not address the use of alternative dyes or fluorescence methods outside the acute surgical context. To gather further insights in fluorescence guidance within acute care, we welcome articles addressing, but not limited to, the following themes:
• Optimization and safety of ICG dosing in emergency surgeries
• Techniques in quantitative intraoperative fluorescence and perfusion assessment
• Role of handheld and robotic NIR devices in trauma and acute surgical care
• Implementation in cholecystectomy and techniques for bile duct visualization
• Strategies for early ischemia detection and prevention of anastomotic leaks
• Comparative studies of fluorescence-guided versus conventional surgery
• Clinical protocol development and perioperative workflow integration
• Long-term outcomes and cost-effectiveness of fluorescence-guided interventions

If appropriate for this Research Topic, we invite submissions including Brief Research Report, Case Report, Clinical Trial, Correction, Curriculum, Instruction, and Pedagogy, Editorial, FAIR² Data, General Commentary, Hypothesis and Theory, Methods, Mini Review, Opinion, Original Research, Perspective, Review, Study Protocol, Systematic Review, Technology and Code.

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Revolutionizing Surgery: ICG Fluorescence-Guided Surgery in Acute Care Settings

Topic Coordinator